CN115363830A - 快速锁定夹具结构和相关方法 - Google Patents
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Abstract
涉及一种快速锁定夹具结构和相关方法。举例来说,公开的植入物可包括第一植入物收纳器和第二植入物收纳器,其各自具有通过臂部分连接在一起的上部部分和下部部分。举例来说,在各种实施例中,所述上部和下部部分可限定在每个植入物收纳器的纵向方向上延伸穿过所述上部和下部部分的纵向通道,并且所述臂部分可各自限定在横向方向上延伸的杆通道。在各种实施例中,每个收纳器可包括冠,所述冠具有螺纹接合在所述纵向通道内并且用于与具有类似内螺纹图案的对应螺母配合的外螺纹图案。在各种实施例中,杆可在所述横向方向上延伸穿过所述杆通道。在各种实施例中,在未拧紧位置,所述杆可自由移动,并且在拧紧位置,所述臂限制所述杆移动。
Description
相关申请的交叉引用
本申请通过引用并入2017年1月25日提交的标题为《脊柱植入物系统和使用方法(Spinal Implant System and Methods of Use)》的美国专利第10,335,201号;2017年9月12日提交的标题为《脊柱植入物系统和使用方法(Spinal Implant System and Methodsof Use)》的美国专利第10,653,455号;2002年7月1日提交的标题为《杆复位器器械和方法(Rod Reducer Instruments and Methods)》的美国专利第6,790,209号;2021年2月4日提交的标题为《用于锁定骨科螺钉的器械(Instrument for locking Orthopedic Screws)》的美国申请第17/167,258号;和2021年2月3日提交的标题为《组合紧定螺钉中断和突片中断器器械(Combination Set Screw Breakoff and Tab Breaker Instrument)》的美国申请第17/104,897号。每个的全部内容以引用的方式并入本文中。
技术领域
本公开总体上涉及用于治疗肌肉骨骼病症的医疗装置,并且更具体地涉及用于治疗脊柱的脊柱植入物系统和方法。
背景技术
脊柱病理学和病症,诸如脊柱侧凸、脊柱后凸和其它曲度异常、退行性椎间盘疾病、椎间盘突出、骨质疏松症、腰椎滑脱、狭窄、肿瘤和骨折,可由包括创伤、疾病和由损伤和老化引起的退行性病况的因素引起。脊柱病症通常导致包括畸形、疼痛、神经损伤和部分或完全丧失活动能力的症状。
非手术治疗,例如药物治疗、康复和锻炼可能是有效的,然而,可能不能缓解与这些病症相关的症状。这些脊柱病症的外科治疗包括矫正、融合、固定、椎间盘切除术、椎板切除术和可植入假体。作为这些外科手术治疗的一部分,脊柱构建物如椎骨杆常常用来为治疗区提供稳定性。在发生愈合时,杆远离受损或有缺陷的区域重新导向应力,以恢复适当的对准且总体上支撑椎骨部件。在手术治疗期间,可将一个或多个杆、脊柱构建物和骨紧固件递送到手术部位。杆可经由脊柱构建物和/或多个脊柱构建物独立地附接到两个或更多个椎骨构件的外部。本公开描述优于这些先前技术的改进。
发明内容
本公开的技术大体上涉及脊柱构建物。在各种实施例中,脊柱构建物可包括两个植入物收纳器,其可在其侧支撑杆并且夹在杆上以将杆相对于植入物收纳器固定。此外,植入物收纳器可分别连接到一对骨螺钉。在一些实施例中,可预组装支撑杆的一对植入物收纳器以用于快速安装和/或易于安装,并且杆可以任选地预先成型。
在一个方面,本公开提供了一种植入物。举例来说,植入物可包括第一植入物收纳器,所述第一植入物收纳器具有通过第一臂连接在一起的第一上部部分和第一下部部分。举例来说,在各种实施例中,第一上部部分和第一下部部分限定在纵向方向上延伸穿过第一上部部分和第一下部部分的第一纵向通道,并且第一臂限定在横向方向上延伸的第一杆通道。举例来说,植入物可包括第二植入物收纳器,所述第二植入物收纳器具有通过第二臂连接在一起的第二上部部分和第二下部部分。举例来说,在各种实施例中,第二上部部分和第二下部部分限定在纵向方向上延伸穿过第二上部部分和第二下部部分的第二纵向通道,并且第二臂限定在横向方向上延伸的第二杆通道。举例来说,在各种实施例中,可提供第一冠,所述第一冠具有沿第一冠的外圆周表面延伸并且具有与第一纵向通道的尺寸和形状相对应的尺寸和形状的第一外螺纹图案。举例来说,在各种实施例中,可以提供第二冠,所述第二冠具有沿第二冠的外圆周表面延伸并且具有与第二纵向通道的尺寸和形状相对应的尺寸和形状的第二外螺纹图案。另外,例如,可提供第一螺母,所述第一螺母具有沿第一螺母的内圆周表面延伸并且具有与第一外螺纹图案的尺寸和形状相对应的尺寸和形状的第一内螺纹图案。另外,例如,可提供第二螺母,所述第二螺母具有沿第二螺母的内圆周表面延伸并且具有与第二外螺纹图案的尺寸和形状对应的尺寸和形状的第二内螺纹图案。举例来说,在各种实施例中,可提供在横向方向上延伸穿过第一和第二横向通道的杆。举例来说,在各种实施例中,在未拧紧位置,杆可在横向方向上自由移动穿过第一和第二横向通道。在各种实施例中,在拧紧位置,第一螺母和第二螺母分别与第一冠和第二冠进行螺纹接合,并且第一臂和第二臂直接接触并限制杆在横向方向和/或纵向方向上移动。
在另一个方面,公开一种用于安装脊柱植入物的方法。举例来说,方法可包括提供预组装的植入物,所述植入物在手术前在制造设施中或在手术前在手术前计划期间至少部分组装。举例来说,预组装植入物可包括第一植入物收纳器,所述第一植入物收纳器具有通过第一臂连接在一起的第一上部部分和第一下部部分。举例来说,在各种实施例中,第一上部部分和第一下部部分限定在纵向方向上延伸穿过第一上部部分和第一下部部分的第一纵向通道,并且第一臂限定在横向方向上延伸的第一杆通道。举例来说,植入物可包括第二植入物收纳器,所述第二植入物收纳器具有通过第二臂连接在一起的第二上部部分和第二下部部分。举例来说,在各种实施例中,第二上部部分和第二下部部分限定在纵向方向上延伸穿过第二上部部分和第二下部部分的第二纵向通道,并且第二臂限定在横向方向上延伸的第二杆通道。举例来说,在各种实施例中,可提供第一冠,所述第一冠具有沿第一冠的外圆周表面延伸并且具有与第一纵向通道的尺寸和形状相对应的尺寸和形状的第一外螺纹图案。举例来说,在各种实施例中,可以提供第二冠,所述第二冠具有沿第二冠的外圆周表面延伸并且具有与第二纵向通道的尺寸和形状相对应的尺寸和形状的第二外螺纹图案。另外,例如,可提供第一螺母,所述第一螺母具有沿第一螺母的内圆周表面延伸并且具有与第一外螺纹图案的尺寸和形状相对应的尺寸和形状的第一内螺纹图案。另外,例如,可提供第二螺母,所述第二螺母具有沿第二螺母的内圆周表面延伸并且具有与第二外螺纹图案的尺寸和形状对应的尺寸和形状的第二内螺纹图案。举例来说,在各种实施例中,可提供在横向方向上延伸穿过第一和第二横向通道的杆。举例来说,方法还可包括以下步骤:将第一和第二骨螺钉固定到患者;和将预组装的脊柱植入物固定到第一和第二骨螺钉。
本公开的一个或多个方面的细节在附图和以下描述中阐述。本公开中所述的技术的其它特征、目的以及优点将根据具体实施方式和附图以及权利要求书而变得显而易见。
附图说明
图1为脊柱植入物系统的透视图。
图2为脊柱植入物系统的侧视图。
图3为脊柱植入物系统的预组装部分的透视图。
图4A为与公开的脊柱植入物系统一起使用的收纳器的侧视图。
图4B为与公开的脊柱植入物系统一起使用的收纳器的俯视图。
图5为脊柱植入物系统的透视图分解零件图。
图6为收纳器和用于连接到骨螺钉的各个部件的透视图分解零件图。
图7A为脊柱植入物系统的侧视横截面视图。
图7B为脊柱植入物系统的侧视横截面视图。
图8为与公开的脊柱植入物系统一起使用的杆的透视图。
图9为在牢固地联接到一对骨螺钉之前脊柱植入物系统的预组装部分的侧视图。
图10为在牢固地联接到一对骨螺钉之后脊柱植入物系统的预组装部分的侧视图。
图11为公开的脊柱植入物实施例的实例使用方法的流程图。
具体实施方式
本公开的实施例大体上涉及例如脊柱稳定系统,且更具体地涉及侧载式脊柱构建物。在一些实施例中,侧载式脊柱构建物可包括两个植入物收纳器,其可分别支撑杆并连接到一对骨螺钉。在一些实施例中,两个植入物收纳器和杆可任选地预组装以用于快速安装和/或易于安装到所述一对骨螺钉。下文参考附图描述装置和方法的实施例。
以下讨论省略或仅简要描述与医疗植入物、安装工具和相关外科技术相关的某些部件、特征和功能,这些对于所属领域的一般技术人员来说是显而易见的。应注意,参考附图详细描述了各种实施例,其中贯穿其中可能的若干视图,相似的附图标记表示相似的零件和组件。对各种实施例的参考不限制所附权利要求书的范围,因为实施例为本文中所描述的本发明概念的实例。此外,在本说明书中阐述的任何(一个或多个)实例旨在是非限制性的,并且阐述适用于所附权利要求书的许多可能实施例中的一些实施例。另外,除非上下文或其它语句另外清楚地指示,否则本文中所描述的特定特征可在各种可能的组合和排列中的每一种组合和排列中与其它描述的特征组合使用。
如本文所用,如“相同”、“相等”、“平面”、“共面”、“平行”、“垂直”等术语旨在涵盖完全相同的含义,同时还包括例如由于制造方法可能发生的变化。除非上下文或其它语句另外清楚地指示,否则术语“基本上”可在本文中用于强调此含义,特别是当所描述的实施例具有相同或几乎相同的功能或特性时。
大体上参考图1-10,公开各种脊柱植入物系统100。图11公开各种公开的脊柱植入物系统100的使用方法。脊柱植入物系统100的部件可由适合于医疗应用的生物可接受的材料制造,包括金属、合成聚合物、陶瓷和骨材料和/或其复合物。举例来说,脊柱植入物系统100的部件可单独地或共同地由以下材料制造:如不锈钢合金、市售纯钛、钛合金、5级钛、超弹性钛合金、钴-铬合金、超弹性金属合金(例如,镍钛诺(Nitinol)、超级弹塑性金属,如GUM)、陶瓷和其复合物,如磷酸钙(例如,SKELITETM)、热塑性塑料,如聚芳醚酮(PAEK),包括聚醚醚酮(PEEK)、聚醚酮酮(PEKK)和聚醚酮(PEK)、碳-PEEK复合物、PEEK-BaSO4聚合橡胶、聚对苯二甲酸乙二酯(PET))、织物、硅酮、聚氨基甲酸酯、硅酮-聚氨基甲酸酯共聚物、聚合橡胶、聚烯烃橡胶、水凝胶、半刚性和刚性材料、弹性体、橡胶、热塑性弹性体、热固性弹性体、弹性复合物、刚性聚合物,包括聚亚苯基、聚酰胺、聚酰亚胺、聚醚酰亚胺、聚乙烯、环氧树脂、骨材料,包括自体移植、同种异体移植、异种移植或转基因皮质骨和/或皮质海绵骨以及组织生长或分化因子、可部分吸收的材料,例如金属与钙基陶瓷的复合物、PEEK与钙基陶瓷的复合物、PEEK与可吸收聚合物的复合物、可完全吸收的材料,例如钙基陶瓷,如磷酸钙、磷酸三钙(TCP)、羟基磷灰石(HA)-TCP、硫酸钙或其它可吸收聚合物,如聚交酯、聚乙交酯、聚酪氨酸碳酸酯、聚己内酯和其组合。
脊柱植入物系统100的各个部件可具有包括上述材料的材料复合物,以实现各种期望特性,如强度、刚性、弹性、顺应性、生物力学性能、耐久性和射线可透性或成像偏好。举例来说,脊柱植入系统100的部件还可单独地或共同地由非均质材料制造,如上述材料中的两种或更多种的组合。脊柱植入系统100的部件可整体形成,一体地连接或包括紧固元件和/或器械,如本文所述。
图1为脊柱植入物系统100的透视图,并且图2为脊柱植入物系统100的侧视图。脊柱植入物系统100可包括第一植入物收纳器20和第二植入物收纳器20。在实例实施例中,第一和第二植入物收纳器20为相同类型的植入物收纳器。然而,在其它实施例中,第一和第二植入物收纳器20可大体上相同和或彼此类似。举例来说,第一和第二植入物收纳器20可各自包括用于收纳杆40的通道22。此外,第一和第二植入物收纳器20可分别包括第一和第二螺母50。举例来说,螺母50可在垂直方向上向上和向下移动,在图2中标记为X方向,以将杆40固定在通道22内。举例来说,在一些实施例中,螺母50可为具有中断部分的中断紧定螺钉。举例来说,在其它实施例中,螺母50可为没有中断部分的实心紧定螺钉。在实例实施例中,母50包括内螺纹图案51和外驱动表面52。举例来说,外部驱动表面52可包括多个径向安置的平面表面,用于用扳手、驱动套筒等驱动螺母50。
在实例实施例中,每个通道22可包含延伸穿过植入物收纳器20的侧的孔。举例来说,第一和第二植入物收纳器20的通道22可安置在植入物收纳器20的侧部分上。再举例来说,植入物收纳器20可为侧载式植入物收纳器。在实例实施例中,植入物收纳器20各自包括通过臂29连接在一起的上部部分23和下部部分21。在各种实施例中,臂29可包含邻接上部部分23和下部部分21的C形部分。举例来说,在实例实施例中,臂29的内圆周表面限定用于收纳杆40的通道22。通道22可在植入物收纳器20的上端23和植入物收纳器20的下端21处封闭,使得杆40在两个维度上被限制在通道22内。举例来说,在各种实施例中,通道22可将杆40限制在竖直方向(在图2中标记为X方向)和横向方向(在图2中标记为Z方向),但仍允许在水平方向(在图2中标记为Y方向)一些滑动。举例来说,通道22的周边由于臂29的内圆周表面而在垂直方向和横向方向上封闭。举例来说,如图2所示,杆40在垂直方向和横向方向上被通道22限制,但可允许在水平方向上移动。然而,如图8所示,例如,一些实施例可使用具有封闭端盖46的替代杆45,这可限制杆45在水平方向上移动太远而滑出通道22。
图4A为植入物收纳器20的俯视图,并且图4B为植入物收纳器20的侧视图。举例来说,在实例图示中,植入物收纳器20可包括用于可旋转地支撑和收纳冠2和螺母50的通道24。举例来说,通道24可在下部部分21和/或上部部分23处带螺纹。通道24可在垂直方向(也可以称为纵向方向)上延伸并且限定竖直轴线A-A,冠2和螺母50可在其旋转时沿所述轴线向上和向下移动。此外,例如,植入物收纳器20可包括用于收纳杆40的单独通道22。举例来说,通道22可在水平方向(也可以称为横向方向)上延伸并且限定水平轴线B-B,杆40可与所述水平轴线同轴对准和/或在基本上平行的方向上延伸。在各种实施例中,通道22在垂直于通道24的方向上延伸。此外,例如,在平面图中,通道22可横向向外安置到通道24的侧。举例来说,通道22偏移到通道24的侧,如图4A-4B通过轴线A-A和B-B的偏移性质所示。在实例实施例中,通道22可类似于圆圈和/或近似圆圈形状,具有面向通道24的开口端。举例来说,通道22可为具有容纳杆40的内径的C形通道,并且C形通道可通过拧紧螺母50封闭和/或变窄。举例来说,在其它实施例中,通道22可类似于椭圆形和/或近似椭圆形形状,或正方形形状。举例来说,在各种实施例中,通道22可具有大体上与杆40的尺寸和形状对应的尺寸和形状。举例来说,在其中螺母50未完全拧紧的未拧紧位置,通道22的直径可相对较大,并允许杆40自由地前后移动穿过通道22。在其中螺母50完全拧紧的拧紧位置,通道22的直径可相对较小并且夹在杆40上,使得杆40被固定在适当的位置。举例来说,在各种实施例中,杆40的侧视图横截面可具有大体上与通道22的尺寸和形状对应的椭圆形形状。
图5为脊柱植入物系统100的侧视图分解零件图,并且图6为脊柱植入物系统100的透视图分解零件图。在实例图示中,示出冠2可包括外螺纹图案4和用于驱动冠2穿过植入物收纳器20的通道24的驱动孔3。举例来说,冠2可从上方插入通道24内并由驱动工具旋转,所述驱动工具将冠2向下移动穿过通道24。驱动孔3可采用任何形状,例如内六角形、六角形、梅花形等。举例来说,螺母50可具有内螺纹图案51,所述内螺纹图案51具有正时和/或螺距,包括大体上与冠2的外螺纹4的正时和或螺距对应尺寸和形状。此外,例如,螺母50可包括内螺纹图案51和外驱动表面52,用于用驱动工具(未示出)驱动螺母50以旋转螺母50。在各种实施例中,冠2的外螺纹样式4的螺距和/或正时可与螺母50的内螺纹样式51的螺距和/或正时对应。
举例来说,在操作中,最终用户可通过在驱动孔3处拧紧冠4使得冠4沿垂直轴线A-A向下推进穿过通道24并固定到骨螺钉10的头部部分,从而将第一和第二植入物收纳器20固定到第一和第二骨螺钉10。此后,最终用户可通过牢固地拧紧螺母50将杆40固定在杆通道22内。举例来说,螺母50可旋转,使得螺母50沿冠2的外螺纹样式4向下推进,使得螺母50沿垂直轴线A-A向下推进。在向下推进螺母50时,螺母50将上部部分23和下部部分21朝向彼此压缩和/或推动。举例来说,因为上部部分23和下部部分21通过臂部分29在一端邻接,所以臂部分29允许上部部分23和下部部分21通过臂部分29处的弹性变形朝向彼此推动。
图6为与公开的脊柱植入物系统100一起使用的植入物收纳器20的透视图分解零件图。举例来说,在实例图示中,示出植入物收纳器20可包括具有下部空腔的基座部分21,所述下部空腔被配置成牢固地联接到骨螺钉10并且将冠2支撑在骨螺钉10的头部部分11上方的位置。冠2可包括带螺纹的外表面4,其可与基座部分21的对应的内螺纹图案25接合(参见图7A和7B)。脊柱植入物系统100还可包括上部环8和下部环9。举例来说,上部环8和下部环9可为C形的并且被配置成将骨螺钉10的头部部分11牢固地联接在基座部分21的下部空腔内。植入物收纳器20可如何经由基座部分21的内空腔牢固地连接到骨螺钉10的附加实例还详细地公开于以下中的每个中:标题为《脊柱植入物系统和使用方法》的美国专利第10,335,201号;和标题为《脊柱植入物系统和使用方法》的美国专利第10,653,455号;标题为《用于锁定骨科螺钉的器械》的美国申请第17/167,258号,所述专利均以其全文引用的方式并入本文中。此外,例如,脊柱植入物系统100可包括可安置在通道22内的杆夹具30。举例来说,杆夹具30在透视图中可具有环形形状(参见图5),并且在截面图中可具有C形形状,具有切口部分。此外,在各种实施例中,通道22可包括便于定位杆夹具30的各种轮廓。此外,例如,杆夹具30可在其前侧和后侧包括边缘部分31。举例来说,边缘部分31可便于将杆夹具30定位在通道22内的中心位置。另外,并且部分由于杆夹具30的环形形状,例如,在各种实施例中,杆夹具30可允许定位在其中的杆40在横向方向和垂直方向上适度地移动约5度至约10度。当在安装骨螺钉10之后将杆40和/或成型杆40安装成特定的对准时,这可能是特别有利的。举例来说,在一些手术设置中,可仅可能将骨螺钉10安装在特定位置,并且经由杆夹具30允许杆40的一些操纵性可有助于最终构建物的最终定位和/或内部装载。在其它实施例(未示出)中,杆夹具30被设计成防止前述适度运动。举例来说,一旦螺母50被充分拧紧,杆夹具30可压缩并提供对杆40的夹紧力。
图7A和7B为脊柱植入物系统100的侧视横截面视图。在实例图示中,第一和第二植入物收纳器20牢固地联接到骨螺钉10。举例来说,外科医生可通过例如用于锁定骨科外科螺钉的器械将每个植入物收纳器20向下推靠在骨螺钉10上,将第一和第二植入物收纳器20联接到相应的骨螺钉10。在各种实施例中,外科医生可同时向下推动每个植入物收纳器20,并且在其它实施例中,外科医生可依次向下推动每个植入物收纳器20。举例来说,手术器械可向下推动植入物收纳器20,使得例如上部环8和下部环9围绕骨螺钉10的头部部分11安放并嵌套在下部基座部分21的相应空腔8a、9a内并由其保持。此后,外科医生可旋转冠2,使得外螺纹4与植入物收纳器20的下部部分21的对应螺纹25接合,并且冠2在垂直方向(X方向)上向下推进。随着冠2推进,螺钉10的头部部分11可牢固地安放在冠2的下部空腔6内。举例来说,在各种实施例中,下部空腔6可类似于半球形形状或圆顶形状和/或成形为与骨螺钉10的半球形或圆顶形头部部分11对应的半球形或圆顶。
在将上部环8和下部环9安放在对应空腔8a、9a中时,植入物收纳器20可固定到骨螺钉10。尽管本文的讨论和图示是在单轴骨螺钉的背景下进行框定和示出的,但可以设想,在一些实施例中,第一和第二骨螺钉10中的至少一个可被配置为多轴螺钉、矢状角螺钉、椎弓根螺钉、单轴螺钉、单平面螺钉、固定螺钉、锚、组织穿透螺钉、常规螺钉、扩张螺钉。举例来说,植入物收纳器20可以一定角度联接到骨螺钉10。在一些实施例中,骨螺钉10可与楔、锚、按钮、夹子、卡扣、摩擦配件、压缩配件、扩张铆钉、钉、钉子、粘合剂、柱、连接器、固定板和/或柱一起使用,仅举几例可能的实例配置。
一旦植入物收纳器20牢固地联接到骨螺钉10,外科医生就可拧紧螺母50。螺母50的内螺纹图案可与冠2的外螺纹图案4接合,并且螺母50可在垂直方向(X方向)上向下推进。随着螺母50推进,上部部分23和下部部分21靠得更近,从而封闭臂29的C形部分。随着C形部分封闭,压缩力施加到杆夹具30和杆40。举例来说,在螺母50被充分拧紧之后,杆夹具30和杆40可在水平、横向和垂直方向上相对于植入物收纳器20保持在适当位置。
图8为与公开的脊柱植入物系统100一起使用的替代的杆45的透视图。举例来说,杆45的至少一个优点可为端盖46防止杆45滑出第一和第二收纳器20和/或从第一和第二收纳器20分离。此外,通过利用杆45,脊柱植入物系统100或其至少一部分可在开始手术之前在制造设施处和/或在术前计划期间在现场进行预组装。然而,例如,其它系统可预组装并且依赖于杆40,而不是杆45。举例来说,递送预组装的脊柱植入物系统100的另一个优点是外科医生可相对快速地将预组装的脊柱植入物系统100固定到患者的一对相邻椎骨。此外,例如,在各种实施例中,杆45(或杆40)可针对患者特定的解剖结构和/或患者特定的程序进行预成型。
图9和10为预组装的脊柱植入物60的侧视图。举例来说,如图9所示,杆40固定在第一和第二植入物收纳器20的通道22内。如上文所解释,在一些实施例中,杆40可取代杆45。由于第一和第二螺母50被充分拧紧,使得上部部分23和下部部分21靠得更近,从而提供抵靠杆40的夹紧力,杆40可牢固地保持在通道22内。在实例实施例中,脊柱植入物60被预组装并且螺母50和冠2被手指拧紧抵靠所示部件。举例来说,如图10所示,如外科医生的最终用户可同时向下推动第一和第二植入物收纳器20,使得如上文所解释,每个骨螺钉10的头部部分11牢固地联接到对应的植入物收纳器20。
图11为安装预组装的脊柱植入物60的方法200的实例流程图。方法200的以下讨论可包括参考如上文针对上下文解释的脊柱植入物系统100的部件、特征和功能,然而,如下文公开的方法不限于上文公开的特定脊柱植入物系统100实施例。在步骤202,可提供脊柱植入物系统,例如脊柱植入物系统100的预组装的脊柱植入物60等。在步骤204,可将第一骨螺钉10或紧固件和第二骨螺钉10或紧固件固定到患者的解剖结构,例如,可将一对骨螺钉10固定到患者的相邻椎骨。在步骤206,预组装的脊柱植入物60可固定到第一和第二骨螺钉10。在各种实施例中,预组装的脊柱植入物60可相对于骨螺钉10的延伸方向成一角度对准。在各种实施例中,预组装的脊柱植入物60最初可通过向下推动脊柱植入物60而联接到第一和第二骨螺钉10。举例来说,如图10所示,通过向下推动第一和第二植入物收纳器20,第一和第二植入物收纳器20被固定到第一和第二骨螺钉10。再举例来说,可通过如上文所解释向下推动植入物收纳器20并围绕骨螺钉10的头部部分11安放各种锁定环8、9并且将其安放在植入物收纳器20的各种收纳空腔8a、9a内将每个植入物收纳器20固定到对应的骨螺钉10。在一些实施例中,第一和第二植入物收纳器20可通过例如一对类似于标题为《杆复位器器械和方法(Rod Reducer Instruments and Methods)》的美国专利第6,790,209号中描述的杆复位器械的复位器械同时固定到第一和第二骨螺钉,所述专利的全部内容以其全文并入本文中。另外,冠2可旋转,使得骨螺钉10的头部部分11固定在冠2的下部空腔内。在步骤208,可通过充分拧紧第一和第二螺母50将杆40(或杆45)固定在最终位置。举例来说,第一和第二螺母50可通过如扳手或套筒的驱动器械旋转,并且螺母50可沿着垂直轴线A-A向下推进,使得上部部分23和下部部分21靠得更近,从而通过压缩力将杆40保持在适当位置。在一些实施例中,第一和第二螺母50中的每一个的中断部分可中断。举例来说,螺母50中的任一个的中断部分可通过中断器械,例如标题为《组合紧定螺钉中断和突片中断器器械》的美国申请第17/104,897号中公开的器械中断。
应当理解,本文公开的各个方面可以与说明书和附图中具体呈现的组合不同的组合进行组合。举例来说,除非上下文另外清楚地指示,否则来自一个实施例的特征、功能和部件可与另一个实施例组合,反之亦然。类似地,除非上下文另外清楚地指示,否则可省略特征、功能和部件。还应当理解,根据实例,本文所描述的任何过程或方法的动作或事件可以以不同顺序执行,可以添加、合并或完全排除(例如,所有描述的动作和事件对于执行技术可能不是必需的)。
除非本文另有明确定义,否则所有术语都将被赋予其最广泛的可能解释,包括从说明书中暗示的含义以及本领域技术人员理解的和/或在字典、论文等中定义的含义。还必须应注意,如在说明书和所附权利要求中所使用的,单数形式“一/一个(a/an)”和“所述(the)”包括复数指代物,除非另有说明,并且术语“包含(comprises和/或comprising)”,当在本说明书中使用时,指定所述特征、元件和/或组件的存在,但不排除一个或多个其它特征、步骤、操作、元件、组件和/或它们的组的存在或添加。
Claims (15)
1.一种植入物,其包含:
第一植入物收纳器,所述第一植入物收纳器具有通过第一臂连接在一起的第一上部部分和第一下部部分,所述第一上部部分和第一下部部分限定在纵向方向上延伸穿过所述第一上部部分和第一下部部分的第一纵向通道,所述第一臂限定在横向方向上延伸的第一杆通道;
第二植入物收纳器,所述第二植入物收纳器具有通过第二臂连接在一起的第二上部部分和第二下部部分,所述第二上部部分和第二下部部分限定在所述纵向方向上延伸穿过所述第二上部部分和第二下部部分的第二纵向通道,所述第二臂限定在所述横向方向上延伸的第二杆通道;
第一冠,所述第一冠具有沿所述第一冠的外圆周表面延伸并且具有与所述第一纵向通道的尺寸和形状相对应的尺寸和形状的第一外螺纹图案;
第二冠,所述第二冠具有沿所述第二冠的外圆周表面延伸并且具有与所述第二纵向通道的尺寸和形状相对应的尺寸和形状的第二外螺纹图案;
第一螺母,所述第一螺母具有沿所述第一螺母的内圆周表面延伸并且具有与所述第一外螺纹图案的尺寸和形状相对应的尺寸和形状的第一内螺纹图案;
第二螺母,所述第二螺母具有沿所述第二螺母的内圆周表面延伸并且具有与所述第二外螺纹图案的尺寸和形状相对应的尺寸和形状的第二内螺纹图案;和
杆,所述杆在所述横向方向上延伸穿过所述第一和第二横向通道,
其中,在未拧紧位置,所述杆能够在所述横向方向上自由移动穿过所述第一和第二横向通道,并且
其中,在拧紧位置,所述第一螺母和第二螺母分别与所述第一冠和第二冠进行螺纹接合,并且所述第一臂和第二臂直接接触并限制所述杆在所述横向方向和/或纵向方向上移动。
2.根据权利要求1所述的植入物,其中:
所述第一植入物收纳器包括用于联接到第一骨螺钉的第一基座部分,并且
所述第二植入物收纳器包括用于联接到第二骨螺钉的第二基座部分。
3.根据权利要求2所述的植入物,其包含:
具有环形形状的第一杆夹具和具有环形形状的第二杆夹具,并且
其中所述第一杆夹具安置在所述第一杆通道内,并且所述第二杆夹具安置在所述第二杆通道内,并且
其中所述杆延伸穿过所述第一杆夹具的内部和所述第二杆夹具的内部。
4.根据权利要求3所述的植入物,其中所述第一冠和第二冠中的至少一个被配置成提供单轴移动。
5.根据权利要求4所述的植入物,其中,在俯视图中,所述杆在所述横向方向上延伸,使得所述杆安置在所述第一骨螺钉和第二骨螺钉的侧上。
6.根据权利要求1所述的植入物,其中:
所述第一臂包含连接所述第一上部部分和所述第一下部部分的C形,
所述第二臂包含连接所述第二上部部分和所述第二下部部分的C形。
7.根据权利要求1所述的植入物,其中:
所述第一下部部分包含限定所述第一纵向通道的一部分的第一下部螺纹图案,并且
所述第二下部部分包含限定所述第二纵向通道的一部分的第二下部螺纹图案。
8.根据权利要求1所述的植入物,其中所述第一和第二植入物收纳器、所述第一和第二冠、所述第一和第二螺母和所述杆都被预组装在手指拧紧位置。
9.根据权利要求1所述的植入物,其中所述杆包含第一端盖和第二端盖。
10.根据权利要求9所述的植入物,其中所述第一端盖的尺寸大于所述第一杆通道的尺寸,并且所述第二端盖的尺寸大于所述第二杆通道的尺寸。
11.根据权利要求1所述的植入物,其中,在横截面图中,所述杆包含椭圆形形状。
12.根据权利要求11所述的植入物,其中所述第一杆通道和第二杆通道分别包含椭圆形形状。
13.根据权利要求1所述的植入物,其中,在横截面图中,所述杆包含圆形形状。
14.根据权利要求13所述的植入物,其中所述第一和第二通道分别包含圆圈形状。
15.根据权利要求1所述的植入物,其中所述第一和第二螺母为中断螺母。
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US20190329388A1 (en) | 2018-04-27 | 2019-10-31 | Imds Llc | Fastener retention mechanisms |
US10646261B2 (en) | 2018-07-24 | 2020-05-12 | Warsaw Orthopedic, Inc. | Multi-purpose screwdriver and method of use |
US10932841B2 (en) | 2018-07-27 | 2021-03-02 | Warsaw Orthopedic, Inc. | Spinal implant system and method |
US11311314B2 (en) | 2018-07-31 | 2022-04-26 | GetSet Surgical SA | Spinal surgery systems and methods |
US10799300B2 (en) | 2018-10-18 | 2020-10-13 | Warsaw Orthopedic, Inc. | Spinal implant system and method |
US10893910B2 (en) | 2018-10-18 | 2021-01-19 | Warsaw Orthopedic, Inc. | Spinal implant system and method |
US11602337B2 (en) | 2019-04-24 | 2023-03-14 | Nuvasive, Inc. | Transmission assembly |
US11523850B2 (en) | 2019-05-29 | 2022-12-13 | Spine Wave, Inc. | Modular spinal screw yoke inserter |
US11123113B2 (en) | 2019-06-13 | 2021-09-21 | Medos International Sarl | Screw inserter instruments and methods |
US11224472B2 (en) | 2019-06-13 | 2022-01-18 | Medos International Sarl | Screw inserter instruments and methods |
-
2021
- 2021-05-17 US US17/322,028 patent/US11712270B2/en active Active
-
2022
- 2022-03-21 EP EP22163200.3A patent/EP4091561A1/en active Pending
- 2022-05-16 CN CN202210529122.4A patent/CN115363830A/zh active Pending
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US11712270B2 (en) | 2023-08-01 |
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